Allscripts CEO to VA: Look past the EHR and focus on interoperability

Earlier this year, the U.S. Department of Veterans Affairs settled on Cerner as the vendor to replace its Veterans Information Systems and Technology Architecture EHR.

VistA was developed internally by the VA in the 1970s, and in recent years, critics have agonized over its lack of interoperability and how outdated it is.

“… I have decided that VA will adopt the same EHR system as DoD, now known as MHS GENESIS, which at its core consists of Cerner Millennium,” VA Secretary David Shulkin said in June.

One of the major reasons behind the decision, Shulkin said, was that Congress has been encouraging the VA and the Department of Defense to work closely on EHR issues and interoperability. And the DoD, of course, uses a Cerner platform.

In a new blog post, Allscripts CEO Paul Black weighed in, sharing his opinion on the VA’s decision and the road ahead.

“A move to a commercially available, current EHR system promises to provide a solid foundation to better manage the continuity of care,” he wrote near the beginning of the post.

However, Black then shifts his focus to interoperability and care coordination. The need for improvement in these areas is of particular importance, as a RAND analysis shows that more and more veterans are expected to receive healthcare from private providers outside VA facilities.

The first is to “combine and share data in a meaningful way.” There should be an interoperability solution that can bring together patient information from the VA, the DoD and private providers. Said information, which must eventually include mental health data and precision medicine data, should be easily accessible to VA clinicians.

Additionally, the VA needs to find a better way to manage care for at-risk veterans. “Clinicians need to be able to stratify veterans by risk, identify gaps in care and monitor each veteran’s health via digital dashboards that include data from their own EHR and those from across the veteran’s Community Care team,” Black wrote.

Finally, veterans need to have a way to engage in their own care. Black suggests self-scheduling features, outreach functionality and telehealth as potential tools the VA should consider. Data from these options can then be sent back to the VA’s EHR system.

Migrating to a Cerner system is a wise move, but “the capabilities that will magnify the power of that new EHR should also be fast-tracked, in parallel to the EHR, to all caring for our nation’s veterans on existing platforms,” Black concluded.